Despite the increased interest in the disorder, depression is not a new thing and has been treated for as long as there have been doctors. Hippocrates, the father of medicine, diagnosed depressive symptoms referred to as melancholia. It is thought that many of the world’s most famous artists, musicians and others were suffering from one form or depression or another. Van Gogh was thought to have had bipolar disorder in addition to have epileptic syndrome, having seizures especially after drinking absinthe. (Source: Sarason, Sarason, 2008)
Depression was divided into two types: endogenous (from within the body) and neurotic, which is caused by an environmental factor. Depression is not just sadness or an irritable mood that will pass but a more intense and long lasting feelings of these emotions. It also manifests several physical symptoms that can have a great impact on physical health. In turn, this can also change the mental health and worsen the symptoms of depression, leading to a spiral that will leave the sufferer unable to cope. Left untreated, depression can cause death, often by suicide.
Depression affects millions of people: 10% adults, 8% teens and 2% of preteens. There is no real way to estimate its monetary costs in the United States because there are just too many factors to consider, not only directly, but indirectly as well. For a single person that is suffering from a depressive disorder the costs can include a doctor’s care and counseling, medications, time lost from work for appointments as well as on days where the physical and mental pain is too much to deal with.
The condition can increase the risk of developing coronary artery disease, asthma and HIV, in addition to many others. It may also increase the risk of diabetes, heart disease and other diseases in teens, and depressed teens are at increased risk for developing obesity. Depression can worsen the prognosis of these and other conditions, including the increased risk of death from them. In the elderly, depression tends to be chronic and is rarely treated if it is even recognized. In this age group, elderly white men who have depression are most likely to commit suicide.
Types and Symptoms of Depression and Depressive Disorder
Major depression is diagnosed by symptoms that last at least two weeks in a row. The symptoms that are noted are severe enough to interfere with daily activities including working, sleeping, eating and hobbies. Dysthymia is less severe, but it does last longer than major depression. While the person may go about daily routines, they do not feel good about it and may do in what is described as a mechanical manner. For instance, they may eat because it is time to do so, but get no real enjoyment from the food and only eat enough to function.
Bipolar disorder, which is also referred to as manic depression, involves a cycle of two very different behaviors, one manic and one depressive. For some people the episodes may gradually develop from one to the other while for others, the change in mood and behavior can happen suddenly. The depressive behaviors are those as defined by major depression , however the manic cycle is the differentiating aspect of this disorder. During a manic cycle the person may seem to be almost euphoric and upbeat, however it is characterized by many potentially dangerous behaviors including the use of drugs, alcohol and unsafe sexual habits.
The person in a manic cycle may also show bad judgments and may even seem to be disconnected from the world that surrounds them. They may feel that they are more important than they really are or that they have special knowledge or powers.
Some depression can be caused by normal events. For instance, the death of a spouse will undoubtedly make a person feel sad, frightened and alone. They may withdraw from friends and social situations for a time to grieve. They may cry frequently and be unable to eat. They may not sleep at night, or they may only want to sleep. This is not depression; this is a normal emotional response to a life changing event. However, if two years have passed and the person is still not eating or sleeping and is still avoiding social situations, it is possibly a sign of depression.
Depression Diagnosis
Depression is diagnosed by a health professional; ironically, a medical doctor is more likely to be the one to diagnose depression than a mental health professional. The first step is a complete physical and psychological evaluation to rule out organic causes for the symptoms. Some medications can cause some of the familiar symptoms of depression. Lab tests will be done to test for electrolyte imbalances and other physical status. After these results are found to be within normal limits, the doctor will ask several questions, including when the symptoms began and what may have caused the in the beginning.
The Treatment Plan
Depression is typically treated with medications of different types. Some of the most common types are SSRIs, MAOIs, TCAS and others. Each class of medication blocks or enhances a different chemical inside of the brain so that the depressive symptoms can be addressed and dealt with. For instance, SSRIs work to increase the amount of the chemical serotonin in the brain. There are a number of other drugs that are called atypical antidepressants which are not able to be classified as any of those previously listed but are effective for depression anyway.
In addition to medications, most people who have been diagnosed with depression are strongly encouraged to use some form of therapy. There are countless forms of therapy and different levels of counselors that can provide this therapy.
Some Precautions
Some medications may elevate the blood pressure and should be used with caution in those who already have or are at high risk for hypertension. In addition, medications should only be taken as directed and should never be stopped suddenly. Some medications must be stepped down gradually before they are stopped. In addition, some meds can cause other side effects such as sexual dysfunction in both men and women. It is also important that the person who is diagnosed with depression or other depressive disorder find a strong support system for their long term mental and physical health. Families can be very beneficial in these times.
Alternative Therapies
There are a number of other recommendations that the doctor might suggest including exercise and better diet. These will not only help protect the physical health, but can also help the medication to work better. Mild depressive symptoms can be treated this way without the need for medications at all. Profect, a liquid protein supplement from Protica can be used as part of a healthy diet, helping to ensure that the right amount of protein is achieved in the daily diet. It comes in a number of fruit based flavors and supplies a full 25 grams of protein per serving. There are also a number of other strengths of this product. In addition to Profect, there is an all natural alternative called Proasis.
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